Network Development Supervisor

Due to continued growth and success, Doral is adding a Network Development Supervisor to our Network Development team. Primary responsibilities will include overseeing Network Development, preparing all documentation and reporting related to Network Development and tracking progress towards compliant networks. Specific responsibilities include:

Job Duties and Responsibilities:

·  Oversee recruitment of provider networks for new networks and other projects

·  Oversee process flow of Enrollment Specialists to ensure timelines are met

·  Ensure Network Development and Enrollment Specialist reports are prepared accurately, timely and work to automate the reports where applicable

·  Allocate resources appropriately to meet deadlines

·  Monitor Provider networks using GEO and other reports to ensure adequate networks

·  Ensure Doral is meeting client expectations and state requirements in terms of the network

·  Provide recommended solutions to market issues, mainly network adequacy, marketing strategy and provider reimbursement

·  Assist in resolving complaints and issues with providers

·  Ensure staff obtains letters of recommendation from providers

·  Draft Provider Agreements, Restated Agreements and Amendments as needed

·  Assist with recruitment markets focusing high volume and critical providers

·  Attend market conference calls/meetings as needed

·  Organize workflow between network development and other departments to ensure efficient and accurate outcomes

·  Update management team as appropriate on major issues, both internal and external

·  Assist with tracking and monitoring critical, secondary, non panel and no auth Providers

·  Process invoices for payment

·  Approve incoming applications

·  Coordinate and implement appropriate performance management strategies for team members to include: 

o Assist in the hiring process, including interviewing candidates

o Assist, train and motivate team members

o Assist in preparation of performance and wage evaluations in accordance to company policy

o Responsible for attendance and company approved time off for team members

o Participate in the determination and implementation of Performance Improvement Plans and performance management initiatives.

 

Job Requirements:

·  Bachelors degree in Business, Health Care or relevant field

·  Five years experience

·  Knowledge of Provider reimbursement preferred

·  Knowledge of contracting preferred

·  Excellent PC skills with proficiency in MS Office products

·  Excellent oral and written communication skills

·  Negotiation and presentation skills preferred

·  Strong customer service and analytical skills

·  Project management and process improvement skills

·  Ability to supervise staff and work well with others

·  Ability to prioritize and organize multiple tasks and remained organized with multiple interruptions

·  Ability to meet multiple deadlines

·  Ability to travel (approx 5%)